Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA.
Transl Behav Med. 2019 Nov 25;9(6):1157-1162. doi: 10.1093/tbm/ibz121.
Patient-reported outcome (PRO) measures are particularly important in mental health services because patients are the central and essential source of information about their mental health status. PRO measures have the potential to engage patients in meaningful and focused conversations during clinical encounters, but unfortunately they often do not serve this purpose in mental health care. Administration of routine outcome measures has often been viewed by clinicians as an obligatory quality improvement process that takes time away from the clinical encounter. This commentary describes current practical barriers to using PRO measures in practice. Then, focusing specifically on the Veterans Health Administration, a unit of the U.S. Department of Veterans Affairs (VA), we propose processes within which PRO measures in mental health services could support the clinical encounter and enhance patient-centered mental health care. With the increasing number of Accountable Care Organizations and other integrated health-care systems that focus on mental health-care delivery, VA has an opportunity to leverage its long-standing electronic medical record technologies and integrated health system to serve as a model for incorporating PRO measures into mental health-care practices. This commentary provides a vision for the future of mental health delivery by incorporating PRO measures at the VA and in other health-care systems.
患者报告的结果（PRO）测量在心理健康服务中尤为重要，因为患者是其心理健康状况的核心和重要信息来源。PRO 测量有潜力在临床就诊期间让患者参与有意义和重点突出的对话，但遗憾的是，它们在精神卫生保健中往往没有达到这一目的。临床医生通常将常规结果测量的管理视为一种强制性的质量改进过程，这会占用临床就诊时间。本评论描述了当前在实践中使用 PRO 测量的实际障碍。然后，我们特别针对美国退伍军人事务部（VA）的一个单位——退伍军人健康管理局，提出了一些流程，在这些流程中，心理健康服务中的 PRO 测量可以支持临床就诊并增强以患者为中心的心理健康护理。随着越来越多的关注精神卫生保健服务提供的责任医疗组织和其他综合医疗保健系统的出现，VA 有机会利用其长期以来的电子病历技术和综合卫生系统，为将 PRO 测量纳入精神卫生保健实践提供一个模型。本评论通过在 VA 和其他医疗保健系统中纳入 PRO 测量，为未来的精神卫生服务提供了一个愿景。
